Rate Benchmarking
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See a sample rate comparisonCPT 25130 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $430.87 national non-facility rate (2026) · View Medicare rates for 25130 |
| Medicaid Fee Schedule | $346.63 median of the 8 states in the free preview · View Medicaid rates for 25130 |
National average reimbursement for CPT 25130 by major payers:

$607.13
BCBS / Anthem

$607.59
UnitedHealthcare

$631.63
Aetna

$749.77
Cigna
Choose a payer to see a sample of rates for CPT 25130.
Columbia North Hills Hospital Subsidiary Lp, Medical City North Hills
Columbia North Hills Hospital Subsidiary Lp
Northwest Surgery Center, LLP, Northwest Surgery Center
Northwest Surgery Center LLP
Potomac View Surgery Center, LLC
Potomac View Surgery Center LLC
Alderwood Surgery Center LLC
Alderwood Surgical Center
Ruxton Surgicenter LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 25130 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 25130. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 25130-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones In The Hand. |
| 25135-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 25136-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 25210-CPT | Moderate | Carpectomy Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25130 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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